Category Archives: medication

The sunlight flowed into the room, bouncing off the parquet floor and spiraling up toward the white walls as women began to stroll in, bedecked in yoga pants, nursing tops, and covered in infants. Soft music played in the background as the waterfall in the front of the room bubbled and sputtered to life.

A woman entered the room once all the mothers were settled and latched their infants. She sat down in the front, her curly hair spilling down her back, nearly reaching the floor. As she adjusted her body into a seated pose, she began to hum as she reached her arms toward the ceiling, which was sprinkled with skylights to invite even more warm rays into the meditation room.

The mothers hummed along with her, deeply breathing in the soothing surroundings and welcoming the excise of the chaos of their lives outside of the room. Breath in, exhale out. Breathe in, ohm out. OHMMMMMMMMM.

For forty five minutes they did this, breathing in, breathing out, letting their minds clear of everything and anything that might possibly distract them from their current state of bliss. OHHHHMMMMMMMM.

Upon closing, the waterfall slowed, the chimes ceased as the water no longer washed over them. Their guide stood, and made her way to the exit.

The women gathered their things, and went on their way. They’d be back tomorrow, they said to each other. For now, let’s all go to Whole Foods and buy only organic foods and supplements because we absolutely cannot let this motherhood thing get us sad. And then, we’ll meet in the garden at the park to pray fervently to keep the negative feelings away from our hearts.

With a spring in their steps and a clear path ahead of them, they all wished each other Namaste as they meandered away to fulfill their guaranteed destinies of avoiding depression after giving birth…without turning to the evils of medicine or therapy like that one mother over there. She cheated, they said, among themselves, as they unlocked their cars and settled their infants in for the quick drive to the Whole Foods. She’s not Ohm like us.

If only it were THAT easy, right?

Oh, I’ll just eat right. I’ll meditate, I’ll pray, I’ll do everything right and *I* won’t get depression after the birth of a child. And if I do, it’s totally big pharma’s fault because all they want to do is sell me drugs which will get me better.

STOP.

Nope. Hippocrates wrote about postpartum depression way back in the day – (you know, old school.. the father of modern medicine theology/ethics?) so this isn’t some new-fangled disorder created by Big Pharma just to get you to part with your money.

There’s been an irresponsible post by Marianne Williamson on Facebook regarding the recent announcement recommending mothers be screened for depression both during and after pregnancy is like giving stigma a nice fat hug. Follow the money, she says. Meditate more, she says. Pray more, she says. LOVE more. But dear heavens, leave big Pharma out of any possible solution because they prescribe meds like candy.

Know what, Marianne? We tell moms to run like hell from doctors who practice medicine that way. We empower them to rule out physical causes before just popping a pill. We tell them that hormonal changes are normal and what to look for beyond those changes. We follow the research. We follow the stories of the mothers who share them with us. We do not muffle their voices. We do not minimize their pain or magnify their shame.

And yet – in one fell swoop, you’ve managed to do exactly what you did not want to do – muffle voices. Do you have any idea how difficult it is for a new mother to speak up about experiencing anything besides joy and happiness after the arrival of a new little one? It’s incredibly difficult. We fight for it every single day. It’s exhausting. But if it helps one..just ONE mother – it’s worth it.

I do want to clarify that if meditation, nutrition, and prayer worked for you – that’s fantastic. I’m truly happy for you. But. It’s important to remember that not all solutions work for all mothers and to discredit one method of treatment which has helped so many is to do a disservice to those it has helped. It’s like giving Stigma a big fat hug and shaming millions into silence because they dared to take meds that HELPED THEM.

Ohm all you want if it helps. Ohm it away. But.

Be open to other methods. Don’t judge others for their journey to wellness.

In 1931, Kurt Gödel, a brilliant mathematician, gained quite a bit of fame with his “Incompleteness Theorem.” What Gödel stated was the following (in non-technical terms thanks to a Wikipedia article):

Any effectively generated theory capable of expressing elementary arithmetic cannot be both consistent and complete. In particular, for any consistent, effectively generated formal theory that proves certain basic arithmetic truths, there is an arithmetical statement that is true,[1] but not provable in the theory (Kleene 1967, p. 250).

Reading this, although directly applicable to mathematics, hit home as an analogy for mental health care and the quest for successful treatment of our conditions as patients.

The equation in our case, at its simplest expression is expressed as such:

whereas P = patient, D = Doctor, C = condition, and T = treatment. But we know all too well that it is not this simple, don’t we? No treatments for mental health are fully consistent nor are they anywhere near complete.

There are too many factors involved to arrive at a simple treatment for the more complex mental health problems. Too many unknowns or additional variables. These variables come in the form of emotional/situational issues with the patient, education/knowledge of the presenting symptoms by the doctor, the symptoms presented by the patient, and the available known data regarding the various symptom sets related to the potential condition diagnoses which is again, limited by the presenting patient and comprehension of said presentation by the attending physician. Therefore, with this equation, we have an infinite amount of possibilities which is essentially what Gödel’s theorem states – that there is an infinite amount of true possible answers but none of them are absolutely provable.

If we take this theory, this Gödel theorem of Incompleteness, we significantly address the reasoning behind the continuing stigma of treatment for mental health in the world today. For instance, let’s address cancer. Most cancers respond to radiation and various forms of chemotherapy, right? Granted, we still lose people to cancer but there is an accepted manner of treatment and no one seems to question that course. It is assumed if one is diagnosed with cancer, he or she will receive some form of radiation or chemotherapy to combat the disease within.

If one is struggling mentally, we hear everything from “suck it up” to “take the natural approach” to “go exercise more” to “take a pill” to “every kind of therapy under the sun” to “eat more chocolate” to “happy light” to “color therapy” to “hospitalization” to…. you get my point. I could keep going for quite some time. There is a sea of possibilities to treat the many various forms of mental health issues which have plagued mankind since the dawn of time.

Even the ancient Greek scholars studied these disorders of the mind and out of these studies, they developed equations which helped them further gain insight into the functioning of the brain we have today. Now, they may have referred to mental imbalance as “black bile” but they were aware that when the mind and body were not connected and in balance, there was something very awry in the state of man. For the Greeks, mental well-being was very closely associated with the health of the body which is why good health was important. As a group of voracious scholars, to be off balance was to fail to be the essence of what their very society represented.

Back to the equation at hand, however. While scholars today struggle to continue to understand the inner workings of the human mind and thereby the issues which cause mental disharmony, we are left with this Incomplete Theorem of care to combat the imbalance inside us.

Gödel’s Theorem in the application of mental health may seem hopeless in the face of stigma because it does not narrow down the understanding of the range of issues so many of us face but there is a silver lining. With the infinite possibilities available for care and those possibilities increasing in effectiveness every day, we are able to fine-tune the available treatments for each patient, thereby increasing the potential for a successful outcome, even if it is just one case at a time.

I am reminded at this time of the story of the hare and the turtle. The hare zooms off past the great oak tree at the top of the hill the beginning of the race while the turtle meanders along the dusty road because well, that’s what turtles do. The hare, winded halfway through the race, stopped to nestle himself among some clover for a quick rest, only to discover the turtle crossed the finish line while he slept. As those around us continue to sleep through the reality that is the challenge of mental health issues, unaware of the battle we fight every second of the day, it is up to those of us who are awake and trudging forward to bring them to the finish line and show them that we are capable of getting there too.

An infinite but unprovable amount of solutions is not a bad thing for us – in fact, it is a rainbow of hope shining across an otherwise dark and stormy sky. Don’t let it go.

On our refrigerator, there is a simple black square magnet with white words in English sprawled across it. This magnet blends in with our refrigerator, making the words even more noticeable as it rests at the top of the freezer door, right in the center. What are these words?

They say this:

“Life begins at the end of your comfort zone.” ~Neale Donald Walsch~

J purchased it for me on a dreary Sunday last winter during a visit to a local art museum. Of all the colorful things in the gift shop, the simplest thing, devoid of any true colour, caught my eye.

Why?

Because the words spoke to me. They challenged me to push myself further than I was comfortable. For the first time in weeks, I felt hope. When we bought the magnet, it was not too long after Sandy roared through our area, leaving me more traumatized than I wanted to admit.

Over the past year, I have pushed myself past my comfort zone. I auditioned in NYC for Listen to Your Mother (and am auditioning again this year, only for Northern New Jersey), I joined an in-person mom’s group, and I am back to pushing myself again after a setback with former neighbors which left me afraid to set foot outside by myself, even after we moved.

Within the past month, I started going back to the gym, I’ve ventured to various places by myself, and I plan to start walking around the neighborhood once it’s not covered under a ton of snow and the temperature won’t turn me into an instant popsicle. Oh, and I am learning how to drive in the snow. Slowly. Don’t laugh, most of my driving years were spent in the deep south where it does not snow often. Yes, I am a Jersey girl and perfectly capable of tolerating the cold but that doesn’t mean I know how to drive in the snow. It’s not that difficult to do, I’m realizing.

I owe this diving out of myself to the courage in asking for help.

I made a phone call back in December to our nurse practitioner to follow up with her about the situation with the neighbors. I saw her back in August due to extreme anxiety because of the situation – anxiety which left me afraid to open the blinds, turn on lights, or do anything beyond sit on the couch and watch TV for nearly 5 days straight. My sleep even suffered and my appetite vanished. I refused to leave the condo, in fact, unless J was with me. I needed help. In August, she prescribed something for anxiety. It worked and got me through the remainder of our time there as well as through our move.

But my prescription ran out.

We were happier at our new place. It was quiet, no screaming children at 11pm, no neighbors calling us names, no trapped in a dark condo. Instead, there was peace, quiet, and a lot of sunshine as all the blinds were opened and the light poured in from every possibly window. I still found myself triggered by certain situations and sounds despite the new tranquil environment. Shell-shocked from the former residence.

Then J was suddenly let go from his job and we faced losing our brand new place. With some careful maneuvering and help from family and a few wonderful friends, as well as some well-timed freelance work, we managed to hang on. He found a job, and has been working steadily. I am still trying to get freelance work going but haven’t lost hope.

While he was unemployed, I was the rock. I did not panic, I held fast and trusted that he would get a job. Once he did, I unraveled – fast. I was wildly unprepared for the roller coaster exit.

J sat me down one night and quietly shared his observances – that he was worried about me, I wasn’t myself. He suggested I call our NP. I struggled with the suggestion. I made it so far without medication. So far. Through a divorce, through the struggle of job-hunting and never hearing anything back, then through Sandy. All of this by myself. I was not sure I wanted to take a pill to get by again. I couldn’t. Could I?

Finally, after realizing every possible option but taking medication had been explored yet I was still struggling, I made that call in December. We talked about SAD (Seasonal Affective Disorder), situational issues, and what medications had worked for me before. I talked quickly, fighting the urge to just hang up. She was wonderful and very non-threatening, telling me that she would call in the script and I could pick it up if I chose to but did not need to feel beholden to it.

I picked it up the next day.

It has been almost 6 weeks and I have picked up a refill.

The medication is helping quite a bit. I am focusing, I am laughing, and I feel more like me.

Going back on a medication felt like defeat. It felt as if I was calling it in, giving up. But I know that I tried everything I possibly could before making that call. Making that call? WAY outside my comfort zone. It is the most uncomfortable thing possible to call your doctor to tell him/her that you are not emotionally stable. Yet, if it were a broken bone, I would have rushed to the ER. Stigma is a pervasive bastard – I hate it.

Every morning now, I swallow hope, in the form of a small white pill.

One day, perhaps I will get to a point where I will simply hold hope in my heart and mind, not in my stomach or blood stream.

But for now, that is where my hope lies, intermingling with my stomach acid and my blood cells flowing through my veins.

I’m okay with that because I know it is without a doubt, what I need to be the best me I can be right now.

I met Erika online through Katherine Stone over at Postpartum Progress. We were asked to participate in a Mother’s Day Rally together. From there, we kind of clicked as we both have had a similar experience with one of our children and occasionally lean on each other for support in that department. And then there’s our passionate love of college football. I’m humbled to have Erika writing here today about Postpartum Depression. She addresses the after-effects of PPD with power and eloquence. I hope you enjoy her piece and have a wonderful weekend!

Health problems sometimes have lingering effects long after treatments are given. For example, I know personally that once you get bronchitis you have a much better chance of having asthmatic symptoms every time you get an upper respiratory illness or the humidity changes a lot. I never had a problem with this until my daughter shared her bronchitis with me a few years ago. I haven’t gotten bronchitis again, but I can’t get too far away from its affect on my life ever since.

The same seems to be true of postpartum depression for me. Between 2000 and 2003, I had postpartum depression and premenstrual dysphoric disorder (like PMS with depression symptoms) following two of my three pregnancies. I eventually got treatment before my third pregnancy, but I still feel the lingering effects of those two problems at times.

During my periods of depression, I had the typical symptoms – crying, low self-worth, negative self talk, withdrawal, etc. Now I find that my anger can burst forth more easily than it used to. When I might have turned inward during my depression, I now turn outward. That’s not an entirely bad thing because my emotions aren’t bottled up. But it can go too far more quickly than I want to admit. I get mad at the dog, my kids, my husband, myself, and so on.

The bigger problem is that this gets noticeably worse during my premenstrual time. Still. After nearly ten years. And I’m using a birth control pill that has helped control the symptoms. I haven’t been honestly depressed in almost a decade and I yet I can’t escape its long term effect entirely.

My point is that in order to get your best quality of life after dealing with depression, you need to really understand how it can affect you after you’ve handled the major symptoms. The stigma surrounding mental illness can be disheartening and confusing. Get it treated, but maybe don’t talk about it so much after that. Or better yet, just get it fixed and don’t pull anyone into an awkward conversation about it. You don’t want to look too selfish or get too much sympathy. Or be seen as incompetent or untrustworthy. And geez, it’s been years, why aren’t you over that?

Here’s the reality – the sooner you treat it the better. And it’s never too late to get treatment because late is still better than never. I firmly believe I would have fewer problems with my long-term effects if I had gotten treatment within a few months instead of waiting nearly three years. The depression would have had less time to make a deep impression on my mind and body. But still, treatment made a critical difference in my life. I don’t truly know how I’d be living if I had to try digging out on my own.

Here’s the good news! These lingering effects don’t necessarily have to make you miserable all the time. I don’t have many conversations about these issues now. I do speak to my doctor at times when my symptoms needed better management, and I find it very helpful to write articles like this or do some public speaking about postpartum depression. I’m also able to handle those tough emotional moments in the moment and recognize what I need to do from there. I don’t allow myself to make my depression history an excuse, but I do recognize the roots of my emotional issues.

Many many women get through postpartum depression and recover well. But it’s realistic for some recovered women to feel ongoing ripples at times. It doesn’t mean you didn’t do a good job of getting through it or that you are broken as a person. That’s just depression for you. It’s a serious condition and requires treatment like many other health problems.

You probably wouldn’t beat yourself up because you had to use a nebulizer years after getting a bad case of bronchitis. You need to give yourself the same break after dealing with postpartum depression. Find what works for you to handle those emotional moments, the negative self-talk, the excess anger, the regrets, or whatever makes you feel stuck again. Develop good self-care habits like regular meals, frequent exercise, lots of social support, and other emotional outlets. When something comes up, you’ll be well-equipped to handle it.

Take care of your mind and body, learn how to recognize your needs, and keep moving forward each day. By the way, it’s mid-October and that means cold season. I’ll be going all out to keep germs away from my lungs, and to be kind to myself when they sneak in anyway.

Erika Krull is a freelance writer and part-time therapist in central Nebraska. She has been married to her college sweetheart for 17 years, stays busy raising three energetic girls and a bouncy puppy, and is still learns so much every day. She writes for the Family Mental Health on psychcentral.com and does local public speaking events about postpartum depression upon request.

Once diagnosed with a Postpartum Mood Disorder, you are then faced with a literal bevy of choices regarding your path to wellness.

Some doctors may toss pills at you. If that happens, run. Run very fast and very far away from any physician who shoves anti-depressants your way before you’ve even finished describing what’s wrong. A good prescribing doctor will sit down with you and hear you out before grabbing for his pen and pad (or these days, keyboard and internet connection). A good physician should also run a couple of simple blood tests first to rule out thyroid disorders or anemia which need completely different types of medication to show improvement.

Some doctors may suggest psychotherapy. And that is where things start to get a little sticky. What kind of talk therapy? Will there be a couch? Will it be comfy? Will I have to talk about how my Great Aunt Edna used to kiss me on the cheeks and leave funny lipstick stains? Will I have to talk about things not related at all to my current state of mind? Will I be hypnotized? Or any other strange mumbo jumbo I’ve seen happen on TV or in the movies or from my best friend who found this website and…

Hold the phone there.

Cognitive Behavioral Therapy proved to be the best option out there for me. There was a couch but I didn’t lay down on it. I sat cross-legged on it as I drank coffee and chatted with my therapist. She sat in a really cool rocking chair with a foot stool. I got along fabulously with my therapist. That’s not to say we were bestest of buds but she knew what she was doing, just let me talk and work a lot of my issues out. I did occasionally talk about things in my past but it wasn’t at all like “So, you were born… let’s start there.” She met me where I was and let things fall where they fell. Or at least she seemed to. She did ask questions to get me to think about issues and how I was reacting to them. I had not planned on staying in therapy for long but once I became pregnant again, I made the decision to stay in through my pregnancy. Therapy gradually stopped at about 6 months postpartum of that pregnancy as we scaled our sessions back.

While I will not be covering every single last type of therapy out there, my goal is to provide some basic information for the most common therapies used with Postpartum women.

At the top of the list is Cognitive Behavioral Therapy which is actually a blanket term for several types of therapies with similar traits. Primarily Cognitive Behavior Therapy (CBT) promotes that WE have power over our moods through our thoughts. You can read more about it by clicking here. A great resource now available for women and clinicians alike when it comes to treating Postpartum Depression is Karen Kleiman’s Therapy and the Postpartum Woman. You can read more about it by clicking here.(In the interest of full disclosure now required by the FTC, I have not been compensated at all for including this link. I sincerely believe it’s a good resource.)

Peer Support/Group therapy is also an option. The primary benefit of this option is the realization it provides to women of not being alone. They really aren’t the only ones having a panic attack when they get in a car or experiencing frightening thoughts prancing through their mind at the most inopportune moments. Many times this option is a cost-effective option as well because many groups do not charge. A group led by a therapist may only charge a small fee such as $10-15 for attending. While peer support should absolutely not replace professional medical care for Postpartum Mood Disorders, it is an important aspect to add to recovery. If your area does not have a local peer group, you can find help online. The Online PPD Support Page has a very active forum for postpartum women. You can also visit the iVillage Postpartum or the Pregnant & Depressed/Mental Illness Boards. (Shameless plug on the iVillage boards, I am the Community Leader for both.)Another bonus of peer support? It reduces the recovery time.

Pharmaceutical therapy is also an available option. Some women are against taking medication and that’s perfectly okay. No one should ever be forced to take medication. Typically, pharmaceutical therapy is paired with another type of therapy. In fact, combining pharmaceutical therapy with a type of Cognitive Behavioral Therapy has proven to be one of the most successful approaches for the Postpartum Woman. Sinead O’Connor really put it best during an appearance on Oprah in regards to the function of psychiatric medications. They are the scaffolding holding you up as you revamp yourself. There are risks involved with taking medications and you should absolutely educate yourself, talk with your doctor, and if you end up deciding to take medication, be sure to inform your child’s pediatrician if you are nursing so they can be involved in monitoring for any potential issues.You should also familiarize yourself with the symptoms of Serotonin Syndrome, a fast-acting reaction which occurs for some people when they do not metabolize medication quickly enough. The build up results in a severe toxic situation. You should also avoid stopping any pharmaceutical therapy without consulting with a physician. Stopping suddenly can cause very negative symptoms similar to Serotonin Syndrome. If you have any signs or symptoms of Serotonin Syndrome, get medical help immediately.

For more serious cases of Postpartum Depression that do not respond to medication, Electroconvulsive Therapy may be suggested. ECT has come a long way since the 50’s and is a viable choice for many women who do not respond to medication. Now, I am not saying that if you choose not to take medication, you’ll be given ECT. This is for women with severe depression who cannot metabolize or do not respond at all to medication. Choosing not to take medication does not buy you an ECT ticket at all.

When I gave birth to my second daughter I saw my dreams of a normal postpartum smashed upon the rocks just 30 minutes after delivery. A delivery after 42 hours of labor, 36 weeks of pregnancy spent un-medicated but largely depressed and unaware of any potential issue facing us. We fully expected (as any parent) a healthy child, normal delivery. A large part of my smashed dreams tied into the hard reality that I would absolutely not be able to nurse her because she was born with a cleft palate so wide and large that it would be physically impossible for us to do so.

Later that day I was faced with a crucial decision. What kind of formula would I prefer for my daughter? I cried. She wasn’t SUPPOSED to get formula! That evening found me hooked up to a hospital grade pump praying for anything to happen. I barely squeezed out a drop. But I persisted and pumped for her faithfully until she was seven months old. I even researched everything I could in order to try to get her to nurse – books, cleft organizations, the La Leche League, the local Lactation consultants and even going to a training to become a trained Certified Lactation Counselor (which I completed one month AFTER we stopped nursing!) I left no stone unturned! Charlotte and I used SNS, nursing shields, and sheer determination. She eventually nursed for almost five minutes! Those five minutes were so amazing words cannot even begin to describe. In fact, it was tears falling from my face which interrupted the glorious event.(You can read more about our journey here: Breastfeeding Charlotte)

But at seven months, I faced a decision. My desire to continue to give breastmilk to my daughter or my mental health which had deteriorated so much it was adversely affecting my relationship with my husband and other daughter. With a heavy heart, I drove to Wal-mart to purchase formula. I cried the whole way home. Eventually I made peace with the decision. “Hanging up the Horns” or HUTH as it’s called in the world of exclusive pumpers, was a difficult decision. But one I was glad to make as it allowed me to bond with my entire family. I had come to resent Charlotte for all the extra work she required. But now, all I had to do was pour, heat, and I was done. I made strides towards better mental health and so did the rest of the family.

For me, the decision centered around the stress providing breastmilk created. I was also on medication which can be another tremendous issue for new moms. Many mothers don’t want anything crossing over to their infant through their breastmilk. Dr. Thomas Hale, author of Medications & Mother’s Milk, is a wonderful authority on the topic as are the researchers at Motherisk in Canada. When nursing while on any medication, it is important for the infant’s pediatrician to be aware of the medication and dosage amount so baby can be monitored for any adverse reaction. The decision to take medication is a personal one and should be made carefully with the help of professionals. Ask questions. Make sure the prescribing physician KNOWS you are nursing. And do not let them force you into quitting nursing if it is the one thing in which you find comfort. If you are currently struggling with this decision, please read this wonderful essay by Karen Kleiman: Is Breast Really Best?

(Absolutely no bashing for deciding to formula feed will be tolerated here. We respect the decision of all mothers to choose the course of treatment/feeding they feel is right for their families. Any posts discrediting or attacking a mother for her decision to formula feed will not be approved.)

On February 23, 2001, Melanie Stokes gave birth to a baby girl. Just three months later, she committed suicide. Melanie’s death gave birth to a very dedicated activist – her mother, Carol Blocker. Frustrated with the failure of physicians to appropriately care for her daughter, Carol worked endlessly to keep Melanie’s tragic death from becoming meaningless. Through Carol’s tireless advocacy and work with Representative Bobby Rush (IL), the Melanie Blocker Stokes Act has now become The MOTHER’S Act.

The MOTHER’S Act as it reads in the current version would provide funds for a public awareness campaign, education campaign for caregivers, increase availability of treatment options and entities as well as require the current Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders.

More and more research is slowly uncovering potential underlying causes and risks related to Postpartum Mood & Anxiety Disorders. More and more women and caregivers are becoming educated as more of those who have survived a PMAD speak up to share our story.

If passed, The MOTHER’S Act would further reduce the stigma surrounding new mothers not ensconced in the Johnson & Johnson glow of infantdom. If passed, the MOTHER’S Act would increase funding for research and possibly open even more doors to understanding the cause and more importantly, the potential for truly preventing Postpartum Mood & Anxiety Disorders. If passed, the MOTHER’S Act has the potential to prevent tragic deaths like that of Melanie Blocker Stokes.

Much of the debate surrounding the MOTHER’S Act has centered on the word “medication.” Medication does not necessarily mean Anti-depressants. It does not mean this is the ONLY way to treat a PMAD. It is merely listed as an option for treatment. And frankly, if one has a doctor with a quicker draw on his/her prescription pad than Billy the Kidd, I’d run away. I’d run away faster than a cheetah.

Another key point of the opposition has been that the MOTHER’S Act mandates screening. In the current version, there is no mandate for screening. The only mention of screening is to require the Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders. The current standard for screening is the Edinburgh Postnatal Depression Scale, which you can learn more about here.

Awhile back, I was contacted by Catherine Elton regarding an article which was to examine Postpartum Depression and the Mother’s Act. The email somehow got buried and I did not get a chance to participate in the discussion.

It seems that it would not have mattered if I had been able to discuss my story with her.

Time published the story this week. While the online version has been modified to correct an error with Ms. Amy Philo’s story, you can still see the original version in the hard copy. (Which by the way, I am personally asking you to boycott – even asking if you can take the copy of TIME home from the doctor’s office in order to keep other moms from reading it! And make sure you ASK – because just taking it would be stealing and that’s illegal.)

The original version, entitled “The Melancholy of Motherhood” includes one quote from Carole Blocker, the mother of Melanie Blocker Stokes, a mother who tragically committed suicide after unsuccessful treatment for severe postpartum depression after the birth of her daughter. The quote reflects Ms. Blocker’s confusion as to how someone could oppose the MOTHER’S Act, a bill which is designed to increase public and professional education regarding Postpartum Mood & Anxiety Disorders. Frankly, I’m confused right along with Ms. Blocker.

Amy has tirelessly worked against this bill for quite some time now but continues to be tragically misled. Few discussions with her have led to quite the round robin with Amy unable to come up with legitimate research to back up her claims. When asked for said research, Amy refers to her own websites instead of to specific research articles supporting her claims.

I happen to know that Ms. Elton did indeed interview fellow survivors who support the bill. One has to wonder then, why did their stories not make it into the article? Was it length? Was it editing? Or was it intentional? Regardless, the finished piece as published presents a very frightening and deceiptful picture of what new mothers face is this bill is passed. To begin with, the MOTHER’S Act no longer mandates screening. It requires a study to be completed by the Secretary of Health and Human Services (Kathleen Sebelius) as well as funds for an educational campaign for both caregivers and the general public.

I agree that just because a new mother shows emotion she should not immediately be diagnosed as having a PMAD. I also believe that a woman should have free choice when it comes to her treatment decisions and should NOT be judged for those choices. I chose to take Anti-depressants. My first prescription did not work out. But my second one did. Just as with any other medication, sometimes they don’t work so well with your system. So you try another one. You don’t suddenly take your own care into your hands – that’s ridiculous. Would you try to heal a broken leg or diabetes on your own? No? I didn’t think so. So why would you rely solely on self-care when it comes to mental illness? Self-care should be part of the picture but it shouldn’t be the ONLY part of the picture.

I am so tired of being judged and accused of not having informed consent. You know what? When I made my decision to go on Anti-Depressants, I had carried around an informational packet about AD’s & Breastfeeding given to me by the NICU Lactation Consultant with me for a week. I read that thing through and through. I was exclusively pumping for my daughter at the time and did not want to jeopardize her receiving my milk if I ended up having to take something. But I couldn’t function. I couldn’t take care of my family, I couldn’t take care of myself, and a lot of the same thoughts were coming back. Negative, scary thoughts about knives and hurting myself and my family. Yet I wasn’t on anti-depressants. I needed to be able to function. So I made a very informed decision to do so, one I do not regret to this day.

TIME – I am very disappointed in your lack of sharing both sides of this debate. Very very disappointed.

Anti-depressants are stigmatized. Period. Nitro-glycerin or insulin? Not so much. Why? Just as Anti-depressants may work for me, they may not work for you. And if you have the wrong heart condition and take nitro-glycerin, things may not go your way either. But you don’t hear people judging others for being on nitro-glycerin, now do you? And insulin? Many Diabetics require this life-saving medication. Even pain medication after an injury – do you question that prescription? Most don’t and certainly aren’t stigmatized for taking it because let’s face it – a broken leg hurts – something we all understand.

Mental illness hurts too. It hurts the person suffering. It hurts the people around them. And if the right medication is paired with the right therapy, it can make a world of difference. Why then, are we stigmatized or accused of not understanding informed consent for deciding (of our own free will) to take medication as we heal? What makes the scaffolding of Anti-depressants any different than pain medication as a broken leg heals?

So I’m posing a pretty big question today. And I expect there will be a bit of debate about it – which is good…our different opinions are what keep us interesting! Just keep things polite. No hateful, judgemental or fear-centered comments will be approved.

Do/did you or don’t/didn’t you take Anti-depressants? Why? Why not?

And more importantly – IS it your place to tell someone else they absolutely SHOULD not take them if you don’t believe in them or have had a bad experience? Or should you calmly refer them to research that explains the risks vs. benefits and let them make the decision on their own WITH a professional on board?

If you’ve landed here as a result of a Google, Yahoo, Bing, or other search engine, you already know how many results you can get in mere seconds and even sometimes nano-seconds. Thousands! So you wade through the results hoping for reliable and trustworthy information. Unfortunately, not everything out there is reliable and trustworthy. And even if it is reliable and trustworthy, you should ALWAYS check with a professional prior to implementing or stopping any treatment.

1. Sponsorship

Can you easily identify the site sponsor? Sponsorship is important because it helps establish the site as respected and dependable. Does the site list advisory board members or consultants? This may give you further insights on the credibility of information published on the site.

The web address itself can provide additional information about the nature of the site and the sponsor’s intent.

A government agency has .gov in the address.

An educational institution is indicated by .edu in the address.

A professional organization such as a scientific or research society will be identified as .org. For example, the American Cancer Society’s website is http://www.cancer.org/.

Commercial sites identified by .com will most often identify the sponsor as a company, for example Merck & Co., the pharmaceutical firm.

What should you know about .com health sites? Commercial sites may represent a specific company or be sponsored by a company using the web for commercial reasons—to sell products. At the same time, many commercial websites have valuable and credible information. Many hospitals have .com in their address. The site should fully disclose the sponsor of the site, including the identities of commercial and noncommercial organizations that have contributed funding, services, or material to the site.

2. Currency

The site should be updated frequently. Health information changes constantly as new information is learned about diseases and treatments through research and patient care. websites should reflect the most up-to-date information.

The website should be consistently available, with the date of the latest revision clearly posted. This usually appears at the bottom of the page.

3. Factual information

Information should be presented in a clear manner. It should be factual (not opinion) and capable of being verified from a primary information source such as the professional literature, abstracts, or links to other web pages.

Information represented as an opinion should be clearly stated and the source should be identified as a qualified professional or organization.

4. Audience

The website should clearly state whether the information is intended for the consumer or the health professional.

Many health information websites have two different areas – one for consumers, one for professionals. The design of the site should make selection of one area over the other clear to the user.

MLA’s guidelines are an excellent starting point and should be used by anyone searching for Medical information on the internet. Many caregivers will also tell you to not search the web for information, especially if you have a Postpartum Mood Disorder. If you have a question and feel overwhelmed with doing research on your own, get in touch with a Postpartum Support International Coordinator, your midwife, or your doctor, and ask for help in doing research. Sometimes you may come across research or news stories that are not applicable to your situation that may cause triggering thoughts or increase your fear and anxiety without justification.

Another great way to check the reliability of a website is to do so through HONcode. HONcode, Health on the Net certifies websites with healthcare information. Their standards are pretty high and they certify on a random basis once a website has been accepted. (I’m currently working on acheiving this certification for this blog myself). Through HONcode, as a patient/consumer, you can download a toolbar or search directly from their site and will only be given websites that have been approved by them. Click here to learn more about the safety process at HONcode.

I also want to take a moment to mention that a good doctor or advocate will be compassionate, understanding, and work with you regarding your desired route of treatment. Good Caregivers and Advocates are able to stay objective and not allow personal experience to cloud their aid to those who seek their help. This does not dismiss advocates who have specialized knowledge of certain types of treatment however – what I mean by this statement is that if you approach and advocate with a question regarding an Anti-Depressant, they should direct you to research regarding that particular medication and encourage you to also speak with your caregiver. They should NOT bash said medication because they’ve had a bad experience with it. If the caregiver or advocate is not compassionate but instead dismisses or attacks your desired treatment methods, it’s time to find another caregiver or advocate for support.

As a Postpartum Support International Coordinator myself, I work very hard to support the journey the mother is on and the treatment route that best fits with her personal philosophy. I encourage the involvement of professionals – including her OB or midwife, a psychiatrist, and a therapist. I also encourage Mom to take time for herself, something we all forget to do from time to time, but is very important for our mental well-being.

So please remember to:

Thoroughly check the source of the information you are reading online using the above guidelines from the Medical Library Association as well as searching via HONcode for your information.

Double-check any information regarding starting treatment or stopping treatment with your professional caregiver prior to implementation.

Make sure your caregiver respects your opinion regarding your body. (You are of course, your #1 expert in this area!) If he/she fails to respect you, although it may be difficult, find another caregiver who DOES respect you!

A Note

Please note any information found on this blog is not meant to replace that of a qualified professional.
We encourage partnership with your physician, psychiatrist, and therapist in the treatment of mood disorder.
The information found here is educational and anecdotal and should be reviewed with a professional prior to implementation.